SINGAPORE SP POLYTECHNIC

DEPARTMENT OF INDUSTRY AND PARTNERSHIPS Singapore Polytechnic

500 Dover Road Singapore 139651 www.sp.edu.sg

LETTER OF CONSENT INTERNSHIP PROGRAM

(For Internship providing no allowance or allowance below the minimum baseline)

• This form is applicable to SP student who is under the internship program (“Program”).

• This form must be duly signed and submitted to the respective School Senior Liaison Officer(“SLO”), at least 4 weeks before the commencement of the Program.

• Student who is under 21 years old must obtain consent from his/her Parents/Guardian.

• If a student faces financial challenges, he is encouraged to pro-actively inform the SLO who canprovide advice on how to seek financial assistance accordingly.

• SLO has to duly inform the student that student cannot negotiate his/her allowance amount norseek to change his/her internship placement after giving consent.

• This Letter of Consent shall be governed by and construed in all respects in accordance with thelaws of Singapore and the parties to this Letter of Consent hereby submit to the non-exclusivejurisdiction of the Singapore Courts.

All information collected in this form will be kept strictly confidential and used only for the purpose of evaluating or administration of internship activities by Singapore Polytechnic and/or conducting of internship activities by Program participants.

1. STUDENT INFORMATIONName of Student

Admission No.

Course Title / Year

Date of Birth

Contact No.

2. COMPANY INFORMATIONName of Company

Company Address

Internship Schedule

Job Scope

Page 1 of 2 Release 1.1 Official (Closed), Sensitive (High) - [Upon Completion]

SINGAPORE SP POLYTECHNIC

DEPARTMENT OF INDUSTRY AND PARTNERSHIPS Singapore Polytechnic

500 Dover Road Singapore 139651 www.sp.edu.sg

3. STUDENT ACKNOWLEDGEMENT AND CONSENT

I (Name as in NRIC/Passport), ________________________________________________, of

Student Administration No. ____________________, confirm that I fully understand the

nature and tasks of the SP Internship Program (“Program”). I am also fully aware that I will

for the duration of the Program.

I understand that I need to be financially and socially independent. I undertake not to hold SP

responsible or liable for the lack of allowance given for my work done in the course of the

Program.

_______________________________ _______________________________ Signature of Student Date

4. PARENT/GUARDIAN’S CONSENT (Applicable to Student under 21 years old)

I (Name as in NRIC/Passport), ____________________________________________________ ,

the * , holder of * __________________________ give

consent for my * (Name as in NRIC/Passport), _______________________________,

to participate in the SP Internship Program (“Program”).

I am fully aware that my will

for the duration of the Program. I will not hold SP responsible or liable for the lack of allowance.

_______________________________ _____________________________________ Signature of Date

* Select where it is applicable Page 2 of 2 Release 1.1

Official (Closed), Sensitive (High) - [Upon Completion]